United Nations Diene Keita: “Accidental Pregnancy May Lead to Forced Marriage”

121 million. This is the staggering number of unwanted pregnancies estimated worldwide each year, the reveals United Nations Fund for the population (UNFPA) who has been investigating the issue for a year. This equates to 331,000 unplanned pregnancies every day that occur earlier than desired or when the woman has no more children planned.

But here is the key statistic from this latest report that allows us to see the magnitude of this crisis: Almost every second woman becomes pregnant unintentionally.

Diene Keita, former Minister of Guinea and Deputy Executive Director of this UN agency, deciphered for Marie Claire this alarming but unrecognized, unrecognized global situation. What does this negligence say about our societies? Do they really care about the basic rights of half the world’s population? Empowerment of women and girls?

Marie Claire : On March 30, 2022, the United Nations Population Fund (UNFPA) presented its annual report entitled “Understanding the Unnoticeable: Taking Action to Solve the Forgotten Crisis of Unwanted Pregnancy”. Why do you call this crisis “forgotten”?

Diene Keita, Deputy General Manager of theUNFPA : It’s forgotten because there have been so many crises on the planet in recent years: Afghanistan, Lebanon, earthquakes in Haiti and collapsing maternity wards, Ukraine… While all this is happening, we forget half of humanity – women – and this global public health emergency.

This crisis is ignored, hidden: nobody sees it, nobody talks about it, because we thought that unwanted pregnancy is a woman’s problem, a very intimate topic, and that we therefore don’t need to talk about it.

By reasoning this way, we forget the socio-economic costs of this question. This forgotten crisis is costing our societies $2.8 billion.

Social exclusion and risks to their health

Where do these millions of women live who did not consciously choose their pregnancy?

These unwanted pregnancies are everywhere: from the least developed to the most developed countries.

However, we find that the higher the level of poverty in a country, the more women become pregnant. Africa is probably the continent hardest hit by this problem — Southern Africa region to be precise, and Uganda at the country level — but Latin America and Asia are also affected.

Which right is more important than bodily autonomy?

What are the risks for those who did not plan to become pregnant?

Which right is more important than bodily autonomy? Deciding whether to father a child or not? And to be supported by his family or society? Well, when it comes to unwanted pregnancies, these basic rights don’t exist…

And the first consequence for these women is the stigma, the humiliation, the indexation of the immediate environment that parents try to avoid by forcing their pregnant daughter into marriage.

And then you have to be able to take care of a birth… These unwanted pregnancies sometimes plunge households into poverty.

Premature pregnancy can also have the disastrous effect of locking some women into an abusive relationship. Sexual violence and reproductive coercion are also one of the causes of unwanted pregnancies: in 64 countries for which we have data, 23% of women in a relationship and of childbearing age cannot refuse sex.

Their study also shows that 60% of unwanted pregnancies end in abortion, and that 45% of those are non-medical. So, do these clandestine abortions represent another serious consequence resulting from these unplanned pregnancies?

We know that fewer women die in countries where abortion is legal than in countries where it is still illegal.

These unwanted pregnancies can lead to unsafe and unsafe abortions. In these uncontrolled peripheral systems, with poor sanitation and doctors whose practice can be very questionable, women can die. Others occur with serious physical and psychological consequences up to lifelong disabilities.

Young girls in danger

Her report recalls that complications related to pregnancy or childbirth are the leading cause of death in young girls aged 15-19. What are the concrete consequences for adolescent girls who did not intend to become pregnant?

An unwanted pregnancy can lead to a forced marriage organized by the family to cover up the event. What two traumas are for a teenager. In addition, these unions often lead to further violence. Conversely, pregnancy that is not the result of a conscious choice by the person concerned is sometimes due to early marriage.

These young girls do not have the physical maturity to support pregnancy. You can die from it.

Either way, it’s a tragedy. These young girls do not have the physical maturity to endure pregnancy, to complete it in complete safety. You can die, your child too. Childbirth can also cause a very serious injury: an obstetric fistula. And there the girl is squeezed for life. Because in some parts of the world there will not be a surgeon who would be able to repair this fistula.

Dropping out of school is another dramatic consequence of unwanted pregnancies. These girls are disappearing from the school system because in some southern countries very few schools accept pregnant girls.

Two other important numbers that we discover in your survey: 257 million women who want to avoid pregnancy are not using modern and safe contraception, and 172 million of them are not using any contraception at all. How do you interpret these results?

birth control is the essential problem. The vast majority of unwanted pregnancies occur because contraception is not available to all women of childbearing age.

Where women want access to safe birth control methods, they are not available. While these products are accessible in other regions of the world, we don’t want to hear about them. The non-use of contraceptive methods can be explained by various factors: in particular cultural and social norms, but also a lack of access to information – including misinformation – on the topic.

This is the goal ofUNFPA : Eliminate all unmet contraceptive needs. That every woman has access to contraception whenever she needs it.

Operate on multiple fronts

What steps must be taken to enable every woman to assert her health, her rights and her choices in matters of sexuality and reproduction?

First, we must improve and guarantee access to contraception. It’s an instant and quick fix. Least developed countries should provide budget lines for contraception so that safe contraceptives are available in public health centres. Without this, the number of unwanted pregnancies will not decrease in the foreseeable future.

Then sex education in schools is fundamental everywhere and at all levels for better access to reliable information. Both girls and boys must receive clear sex education courses so that they understand the importance of contraception in women’s sex life and development.

Finally, health systems that protect women need to be established or strengthened. Believe me, in some countries of the planet there is the unimaginable minimum at this level. Without these government efforts, half of the world’s women will still be pregnant and never achieve freedom of choice. Pregnancy should always be an inspiration, never a death.

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